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Complications of nephrotic syndrome in children
Insights
This retrospective review of pediatric nephrotic syndrome identified significant complications, including hypertension, hypovolemic shock, and bacterial infections, highlighting the need for vigilant management in affected children.
Area of Science:
- Pediatric Nephrology
- Clinical Pediatrics
- Internal Medicine
Background:
- Nephrotic syndrome is a complex kidney disorder in children.
- Acute complications and unusual features require thorough investigation.
Purpose of the Study:
- To retrospectively review acute complications and unusual features of nephrotic syndrome in children.
- To analyze the incidence and characteristics of these events over a decade.
Main Methods:
- Retrospective chart review of 193 children with nephrotic syndrome.
- Analysis of 271 admissions from 1980 to 1989.
- Data collection on complications including hypertension, shock, infections, and other features.
Main Results:
- Hypertension observed in 21.2% of patients.
- Hypovolemic shock occurred in 4.7%, associated with hemoconcentration and hyponatremia.
- Bacterial infections (14.5%) were predominantly gram-negative, with primary peritonitis and sepsis being common.
- Other complications included tetany, thromboembolism, pancreatitis, and Fanconi syndrome.
Conclusions:
- Pediatric nephrotic syndrome presents with a range of acute complications.
- Vigilant monitoring for hypertension, hypovolemic shock, and infections is crucial.
- Gram-negative bacilli are significant pathogens in infections associated with nephrotic syndrome.
Abstract:
One hundred and ninety-three nephrotic children with a total of 271 admissions during the past decade, from 1980 to 1989, were retrospectively reviewed for acute complications and unusual features of nephrotic syndrome. One hundred and forty-nine patients were male, 44 female. Hypertension was found in 41 children (21.2%). Nine patients (4.7%) had a total of 11 episodes of hypovolemic shock. These shock patients had a more severe hemoconcentration (mean hemoglobin concentration 19.6 +/- 1.5 g/dl) and hyponatremia (mean serum sodium 127.5 +/- 8.5 mmole/L). Bacterial infections occurred in 28 children (14.5%) with primary peritonitis in 13, sepsis in 6, cellulitis in 4, urinary tract infection in 4 and osteomyelitis in 1. Almost all infections were caused by gram-negative bacilli. Other complications or features included tetany in 4 (2.1%), thromboembolism in 2 (1.0%), pancreatitis in one (0.5%) and Fanconi syndrome in one (0.5%).